evaluation of the texas wellness incentives and navigation (win) project

Conditions: Chronic Mental Illness; Chronic Physical Illness

Summary: the wellness incentives and navigation (win) project is designed to help improve health self-management and reduce the incidence and consequences of chronic disease among non-elderly adult medicaid supplemental security income (ssi) beneficiaries. win targets ssi beneficiaries with behavioral health (mental health and substance abuse) diagnoses. research demonstrates that these individuals are more likely to suffer chronic physical co-morbidities, experience debilitating chronic illnesses earlier in life and have elevated healthcare costs. win uses person-centered wellness planning and navigation facilitated by trained, professional health navigators, dedicated specifically to the win project, who use motivational interviewing (mi) techniques, and a personal wellness account. participants with more serious mental illnesses will be offered additional support in the form of wellness recovery action planning (wrap) to enable them to take full advantage of person-centered wellness planning.

the texas based wellness incentives and navigation (win) project uses a continuum of evidence-based "whole person" interventions that take into account clinical, environmental, and social risk factors and co-morbidities. unlike more traditional didactic approaches to health management, win addresses individual behavioral, social, and economic barriers to health and wellness, and promotes continued engagement in achieving, internalizing, and maintaining healthy behaviors. the study is focused on non-dual eligible adult star+plus (a texas medicaid managed care program for people with chronic illnesses) members (ages 21-55) with a behavioral health disorder including serious mental illness (smi - e.g., schizophrenia, bipolar disorder or major depressive disorder) or other behavioral health conditions (e.g., anxiety disorder or substance abuse). key features of the program include the use of professional health navigators, working in collaboration with the three star+plus plans in the harris service area (sa) (united-evercare, amerigroup, and molina), the use of motivational interviewing (mi) techniques to help members develop and meet personal wellness goals, and a flexible wellness account for the participant to use in meeting his/her goals.

Eligibility criteria:
inclusion criteria: * be a resident of the harris service area * be a non-dual eligible member of star+plus; * be 21 to 55 years of age; and * have an smi diagnosis (schizophrenia, bi-polar disorder, major depressive disorder); or * other behavioral health diagnoses (e.g., anxiety, depression, substance use disorder) coupled with a chronic health diagnosis (physical health condition). exclusion criteria: * intellectual or cognitive diagnoses indicative of severe cognitive impairment. these could include diagnoses such as 290.x (dementia) and 318-319 (moderate to severe mental retardation).

Keywords: asthma cerebrovascular disease intracranial injury neoplasms heart failure hiv/aids hereditary and degenerative diseases of the central nervous system disorders of the peripheral nervous system rheumatoid arthritis and other inflammatory polyarthropathies history of hepatitis c schizophrenia episodic mood disorders delusional disorders other non-organic psychoses organic psychotic conditions neurotic disorders other non-psychotic mental disorders